Doctors Are Tired of Being 'Fixed' by Congress

Congress got close to replacing Medicare's payment formula but fell back on yet another short-term patch.

Doctors' groups are not happy about Capitol Hill lawmakers' inability to reach agreement on Medicare payments.

The Senate voted 64-35 to pass another short-term "doc fix" on Monday, delaying a 24 percent cut in Medicare's payments to doctors. The one-year patch squeaked through the House last week in a voice vote that many members didn't even know was happening.

And doctors' lobbying associations aren't happy about it. They had high hopes for a solution that would permanently replace Medicare's payment system.

"The physician community made some tough choices and compromises," a representative at one physicians' organization said. "And we didn't really see the same effort put forward on the pay-fors. Frankly, I think that there was a reluctance on both sides of the aisle—on both sides of the Capitol—to make provider cuts, reluctance to make those choices prior to the election."

Since 2003, Congress has passed 16 "doc fixes" to stop automatic cuts put in place by the Sustainable Growth Rate formula used to determine Medicare physicians' pay.

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The Senate's vote is widely viewed among the doctor community as the disappointing conclusion of a long, bipartisan, bicameral effort to come to agreement on a long-term repeal and replacement of that formula. Lawmakers and interest groups reached an agreement on the substance of a new payment formula, but they couldn't agree on how to offset the bill's roughly $140 billion price tag.

"Too many in Congress lacked the courage and wherewithal to permanently fix Medicare to improve care for patients and provide greater certainty for physician practices," Ardis Dee Hoven, president of the American Medical Association, said in an email. "Congressional leadership had to resort to trickery to pass an SGR patch that was opposed by physicians."

The AMA, along with more than 80 other doctors' groups, sent a letter to House leadership condemning the short-term fix.

What a short-term patch means for the legislation that would permanently repeal and replace the SGR formula is unclear: Members of Congress could sit back down to the negotiating table in the fall, after the midterm elections, when they are facing no guillotine if they make unpopular cuts to pay for the bill.

This story was updated at 7 p.m. Eastern to include the Senate vote count.